Detection of Coronary Artery Fistula between the LAD and the Great Cardiac Vein on Coronary CT Angiography

TL;DR

This paper presents a case where coronary CT angiography was used to detect an abnormal connection between a coronary artery and a cardiac vein in a 77-year-old woman.

Contribution

The study highlights the use of non-invasive coronary CT angiography for diagnosing a rare type of coronary artery fistula.

Findings

Coronary CT angiography successfully identified a fistula between the left anterior descending artery and the great cardiac vein.

The case demonstrates the diagnostic capability of CT angiography in visualizing complex coronary anatomy.

The method avoids the need for invasive procedures in diagnosing coronary artery fistulas.

Abstract

Coronary artery fistulas (CAFs) are abnormal communications of coronary arteries whereby venous circuits bypass the normal capillaries within the myocardium. Coronary artery-to-cardiac vein fistula is the third most common type of CAF, accounting for 7% of cases. Electrocardiographic-gated cardiac computed tomographic (CT) angiography has emerged as a noninvasive alternative method of choice for diagnosis due to its high spatial and temporal resolution and short acquisition time. Herein, we aimed to present a left anterior descending coronary artery opened into the greater cardiac vein at the distal level, consistent with a coronary artery-to-cardiac vein fistula in a 77-year-old woman.

Teaching point: Coronary artery CT angiography provides a detailed evaluation of the complex anatomy of coronary artery fistula without the need for invasive methods.

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